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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (26)ACORD-M CERTIFICATE OF LIABILITY INSURANCE DATE. VY) /OB PRODUCER 1-303-534-4567 INA of Colorado, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Suit 1street Suite 00 600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver, CO 80202 INSURERS AFFORDING COVERAGE INSURED Hydro Construction Company, Inc. INSURER A: American Guarantee & Liab. (Zurich American Ins) INSURER s: American Guarantee & Liab. (Zurich N. American Ina) 301 East Lincoln Avenue INSURER C:Pinnacol Assurance INSURER D: Fort Collins, CO 80524 INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR NSq rypE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY CP0343758104 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMSMADE IXIOCCUR FIRE DAMAGE (Anyone fire) $300,000 MED EXP (An one person) $10,000 X PD Ded:$5,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: 1 X PPP X LOD PRODUCTS - COMP/OP ADS $2,000,000 A AUTOMOBILE LIABILITY CP0343758104 09/30/08 09/30/09 X ANY AUTO a accciden) SINGLE LIMIT (E $ 1, 000, 000 ALL OWNED AUTOS SCHEDULED AUTOS BODILYINJURY (Perrper person) $ X HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG B EXCESS LIABILITY X OCCUR CLAIMS MADE AUC593964000 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DEDUCTIBLE X RETENTION $0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 2091550 04/01/08 04/01/09 X WCYTATU OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $1, 000, 000 E.L. DISEASE -POLICY LIMIT I $1, 000, 000 OTHER S S S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re: DWRF Odor Control Covers Procurement. of Fort Collins 300 W. LaPorte Ave. Fort Collins, CO 80522-0000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE USA crunderwood L ✓!� Q 10026852 IFtmm ACORD-M CERTIFICATE OF LIABILITY INSURANCE DATE. VY) /OB PRODUCER 1-303-534-4567 INA of Colorado, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Suit 1street Suite 00 600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver, CO 80202 INSURERS AFFORDING COVERAGE INSURED Hydro Construction Company, Inc. INSURER A: American Guarantee & Liab. (Zurich American Ins) INSURER s: American Guarantee & Liab. (Zurich N. American Ina) 301 East Lincoln Avenue INSURER C:Pinnacol Assurance INSURER D: Fort Collins, CO 80524 INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR NSq rypE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY CP0343758104 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMSMADE IXIOCCUR FIRE DAMAGE (Anyone fire) $300,000 MED EXP (An one person) $10,000 X PD Ded:$5,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: 1 X PPP X LOD PRODUCTS - COMP/OP ADS $2,000,000 A AUTOMOBILE LIABILITY CP0343758104 09/30/08 09/30/09 X ANY AUTO a accciden) SINGLE LIMIT (E $ 1, 000, 000 ALL OWNED AUTOS SCHEDULED AUTOS BODILYINJURY (Perrper person) $ X HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG B EXCESS LIABILITY X OCCUR CLAIMS MADE AUC593964000 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DEDUCTIBLE X RETENTION $0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 2091550 04/01/08 04/01/09 X WCYTATU OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $1, 000, 000 E.L. DISEASE -POLICY LIMIT I $1, 000, 000 OTHER S S S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re: DWRF Odor Control Covers Procurement. of Fort Collins 300 W. LaPorte Ave. Fort Collins, CO 80522-0000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE USA crunderwood L ✓!� Q 10026852 IFtmm IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. 25-S IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. 25-S AA -COS. CERTIFICATE OF LIABILITY INSURANCE DAT08108DVV) 10/08/08 '-PRODUCER 1-303-534-4567 IMA of Colorado, Inc. 1550 17th Street Suite 60o THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE Denver, CO 80202 INSURED Hydro Construction Company, Inc. INSURER A: American Guarantee & Liab. (Zurich American Ina) 301 East Lincoln Avenue INSURERB: American Guarantee & Liab. (Zurich N. American Ins) INSURER C: Pinnacol Assurance Fort Collins, CO 80524 INSURER D: INSURER E: cnvconr_oc THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSfl TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION POLICY NUMBER DATE (MWDDNYI A GENERAL LIABILITY CP0343758104 09/30/08 09/30/09 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCUR X PD Ded:$5,000 LIMITS EACH OCCURRENCE $ 1, 000, 000 FIRED AMAGE(An one fire) $ 3 0 0 , 000 MED EXP (Any one person) $ 10,000 PERSONAL& ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO' 51 LOG PRODUCTS - COMP/OP AGG $2,000,000 A AUTOMOBILE X LIABILITY ANY AUTO CP0343758104 09/30/08 09/30/09 COMBINED SINGLE LIMIT (Ea accident) $1, 0001000 _ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ X HIREDAUTOS X NON OWNED AUTOS BODILY INJURY (Per accident) $ P ROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO - OTHER THAN EA ACC $ $ AUTO ONLY: AGG e EXCESS LIABILITY X OCCUR CLAIMS MADE AUC593964000 09/30/08 09/30/09 EACH OCCURRENCE $ 1, 000, 000 AGGREGATE $ 1,000,000 $ DEDUCTIBLE X RETENTION $ 0 $ C EMPLOY WORKERSCOMPENSATIONON AND EMPLOVERS' LIABILITY 2091550 04/01/08 04/01/09 X WC STATU- DTH- T E.L. EACH ACCIDENT $ 1, 000, 000 E.L. DISEASE - EA EMPLOYE- $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 OTHER 5 S S DESCRIPTION OF OPERATIONS/LOCATIONSNENICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS City of Fort Collins is included as Additional Insured on the General Liability Policy if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. CFGTIrl! ATC UnI nco 11 .--._._.. City of Fort Collins 300 W. LaPorte Ave. Fort Collins, CO 80522-0000 I USA ACORD 25-S (7/97) crunderwood innocRcc SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE ❑e AA -COS. CERTIFICATE OF LIABILITY INSURANCE DAT08108DVV) 10/08/08 '-PRODUCER 1-303-534-4567 IMA of Colorado, Inc. 1550 17th Street Suite 60o THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE Denver, CO 80202 INSURED Hydro Construction Company, Inc. INSURER A: American Guarantee & Liab. (Zurich American Ina) 301 East Lincoln Avenue INSURERB: American Guarantee & Liab. (Zurich N. American Ins) INSURER C: Pinnacol Assurance Fort Collins, CO 80524 INSURER D: INSURER E: cnvconr_oc THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSfl TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION POLICY NUMBER DATE (MWDDNYI A GENERAL LIABILITY CP0343758104 09/30/08 09/30/09 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCUR X PD Ded:$5,000 LIMITS EACH OCCURRENCE $ 1, 000, 000 FIRED AMAGE(An one fire) $ 3 0 0 , 000 MED EXP (Any one person) $ 10,000 PERSONAL& ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO' 51 LOG PRODUCTS - COMP/OP AGG $2,000,000 A AUTOMOBILE X LIABILITY ANY AUTO CP0343758104 09/30/08 09/30/09 COMBINED SINGLE LIMIT (Ea accident) $1, 0001000 _ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ X HIREDAUTOS X NON OWNED AUTOS BODILY INJURY (Per accident) $ P ROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO - OTHER THAN EA ACC $ $ AUTO ONLY: AGG e EXCESS LIABILITY X OCCUR CLAIMS MADE AUC593964000 09/30/08 09/30/09 EACH OCCURRENCE $ 1, 000, 000 AGGREGATE $ 1,000,000 $ DEDUCTIBLE X RETENTION $ 0 $ C EMPLOY WORKERSCOMPENSATIONON AND EMPLOVERS' LIABILITY 2091550 04/01/08 04/01/09 X WC STATU- DTH- T E.L. EACH ACCIDENT $ 1, 000, 000 E.L. DISEASE - EA EMPLOYE- $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 OTHER 5 S S DESCRIPTION OF OPERATIONS/LOCATIONSNENICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS City of Fort Collins is included as Additional Insured on the General Liability Policy if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. CFGTIrl! ATC UnI nco 11 .--._._.. City of Fort Collins 300 W. LaPorte Ave. Fort Collins, CO 80522-0000 I USA ACORD 25-S (7/97) crunderwood innocRcc SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE ❑e IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.